Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Glen Carlisle Mackenzie, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1306926704

Mr. Glen Carlisle Mackenzie, MD is an Obstetrics/Gynecology in Manchester Center, Vermont. Graduated from Loyola University of Chicago, Stritch School of Medicine in 1991, 35 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Vermont.

Years since qualifying
35
Trained at
Loyola University of Chicago, Stritch School of Medicine
Licensed in
VT
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1009 Depot St
Manchester Center, VT 05255-9731
Phone: (802) 442-8649
Fax: (802) 442-8658
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gynecology Physician (primary) Taxonomy 207VG0400X · Licence 0420009174 (VT)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 0420009174 (VT)

Record details

NPI number1306926704
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 17, 2006
Last updated in NPPESJune 17, 2022
Certification dateJune 17, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolLOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduated 1991 (35 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount